Warner J G, Nomeir A M, Salim M, Kitzman D W
Department of Internal Medicine, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27157-1045, USA.
J Am Soc Echocardiogr. 1996 Nov-Dec;9(6):865-73. doi: 10.1016/s0894-7317(96)90479-4.
Although multiplane transesophageal echocardiography has become an accepted diagnostic technique, there is a paucity of literature directly comparing the diagnostic yield of multiplane and biplane transesophageal examinations. This study was designed to compare the ability of multiplane and biplane transesophageal echocardiographic techniques to visualize intracardiac structures. Complete multiplane and biplane transesophageal studies were performed on each of 50 patients (100 total studies) referred to the echocardiography laboratory for elective transesophageal echocardiography. The biplane examinations were performed with a multiplane probe with angles only at 0 and 90 degrees. Images of 29 prospectively selected cardiac structures and valvular function parameters were scored as follows: 0 = not visualized, 1 = visualized well enough to identify structure, 2 = diagnostic quality, and 3 = exceptional quality. The scores for the individual structures were combined to identify total structure visualization quality scores for each of the imaging techniques. A separate subjective score was also determined to assess the overall adequacy of each study for addressing the clinical indication. The total structure visualization quality score was significantly higher for multiplane transesophageal echocardiography than for biplane transesophageal echocardiography (49 +/- 7 versus 45 +/- 7; p = 0.0001). Several individual structures were visualized significantly better (p < 0.05) by the multiplane technique, including the left upper pulmonary vein, fossa ovalis, left main coronary artery, and proximal ascending aorta. The subjective score of overall adequacy of the study for addressing the clinical indication showed a strong trend (p < 0.06) in favor of the multiplane technique, with higher scores in 11 of 50 multiplane studies versus three of 50 biplane studies when the two techniques were compared in individual patients. Therefore multiplane transesophageal echocardiography provides superior overall visualization of intracardiac structures compared with biplane studies, particularly for the left upper pulmonary vein, fossa ovalis, left main coronary artery, and ascending aorta.
尽管多平面经食管超声心动图已成为一种公认的诊断技术，但直接比较多平面和双平面经食管检查诊断率的文献却很匮乏。本研究旨在比较多平面和双平面经食管超声心动图技术观察心内结构的能力。对转诊至超声心动图实验室进行择期经食管超声心动图检查的50例患者（共100项检查）均进行了完整的多平面和双平面经食管检查。双平面检查使用仅能在0度和90度角度成像的多平面探头。对29个预先选定的心脏结构和瓣膜功能参数的图像按以下标准评分：0分=未观察到，1分=观察到的结构足以辨认，2分=诊断质量，3分=极佳质量。将各个结构的评分相加，得出每种成像技术的心内结构整体观察质量评分。还确定了一个单独的主观评分，以评估每项检查对解决临床指征的总体充分性。多平面经食管超声心动图的心内结构整体观察质量评分显著高于双平面经食管超声心动图（49±7比45±7；p=0.0001）。多平面技术观察到的几个单独结构明显更好（p<0.05），包括左上肺静脉、卵圆窝、左冠状动脉主干和升主动脉近端。在个体患者中比较这两种技术时，针对解决临床指征的检查总体充分性主观评分显示出强烈的倾向（p<0.06）支持多平面技术，50项多平面检查中有11项评分较高，而50项双平面检查中只有3项评分较高。因此，与双平面检查相比，多平面经食管超声心动图在心内结构的整体观察方面更具优势，特别是对于左上肺静脉、卵圆窝、左冠状动脉主干和升主动脉。
